• Title/Summary/Keyword: Facial Pain

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T2 Sympathicotomy with TUR Electroresectoscope for Facial Hyperhidrosis (안면다한증에서 경요도 절제용 전기절제 내시경을 이용한 교감신경간 소작술)

  • Choi, Bong-Choon;Lee, Young-Chul;Lee, Hyo-Keun;Kim, Chan
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.220-225
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    • 1998
  • Background: The patients of facial hyperhidrosis have been known that they had much difficulties in interpersonal relationships and social activities due to excessive hidrosis when they were in stress, hot weather, or having meals. Previous drug therapy and stellate ganglion block have only temporary effects. The surgical method, $T_1$ sympathetomy has the risk of Hornor's syndrome. For that reasons, the sympathicotomy of proximal and distal portions of $T_2$ sympathetic ganglion with electroresectoscope used in transurethral resection seemed to be appropriate procedure, and we would like to report the results of our procedure. Method: Under the general anesthesia with semi-sitting position, and the portal was made through the small incision along the upper border of the 4th rib at the crossing point of mid-axillary line. After the partial collapse of lung by insufflation of 300 to 500 ml of $CO_2$, $T_2$ sympathetic ganglion was identified and resected proximally and distally with electro-cauterization. Finally the lung was expanded by limiting flow until the airway pressure reached 30 to 40 cm$H_2O$, and the wound was closed after removal of electroresectoscope. Result: There was no postoperative complication requiring surgical interventions. The facial sweating was stopped immediately after the operation and all the patients appeared to be satisfied. Conclusion: $T_2$ sympathicotomy with TUR electroresectoscope is thought be the minimal invasive and highly successful method in the treatment of facial hyperhidrosis. But longer terms follow-up will be needed to prove this result.

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Case report: Treatment of Facial Nerve Palsy Following Bilateral Sagittal Split Ramus Osteotomy (증례보고 : 양측 하악지 시상골 절단술 후 발생한 안면신경 마비)

  • Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.255-260
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    • 2013
  • Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.

The Assessment for Mandibular Movement and Adult Facial Skeletal Structure According to Angle's Classcification (앵글씨 분류에 의한 성인 골격구조 및 하악운동량 평가)

  • Kim, Jae-Hyung;Kim, Byung-Gook;Choi, Hong-Ran
    • Journal of Oral Medicine and Pain
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    • v.26 no.2
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    • pp.147-156
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    • 2001
  • The purpose of this study was to identify the difference of vertical movement of mandible according to Angle's molar relationship and by skeletal factors affect to vertical movement of mandible. 172(age ranged from 20 to 30) subjects who go to college within territory of Kwangju city without any experience of temporomandibular disorder, extraction and orthodontic treatment. were selected for this study. The subjects were classified into class I(male:30, female:49), class II(male:18, female:24) and class III(male:18, female:33) according to Angle's molar relationship. The distance was measured between incisal edge of maxillary and mandibular central incisor and between bottom of central fossa of maxillary and mandibular 1st molar with ruler. The arch length and width were measured on the diagnostic cast. Cephalometrics were taken and then traced. Landmarks were identified and analyzed. 1. Maximal interincisal opening of male is larger than that of female in class I, class II and class III. Among each group maximal interincisal distance is the largest in class III. Maximal intermolar distance of male is superior to that of female in class I, class II, and class III, but there is no siginficant difference among them. 2. On maximal opening movement of Angle's classification class I and class II, total mandibular length, mandibular ramal length, madibular inferior border length and upper arch width were important variables and facial length, upper arch length and lower arch length had negative relationship to that. On maximal opening movement of Angle's class III, the upper arch length, the lower arch length and anterior facial length were important variables especially when compared with class I and II, and upper arch width had negative relationship. These results suggest that maximal opening movement is affected by facial morphology in all classes, but each group is affected by different facial skeletal variables. Accordingly, facioskeletal variables might be considered as diagnosis and treatment to improve the amount of mouth opening.

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Cephalometric Characteristics of TMD Patients based on RDC/TMD Axis I Diagnosis (RDC/TMD Axis I 진단에 따른 측두하악장애 환자의 측두 두부방사선적 특징에 관한 연구)

  • Ahn, Ji-Yeon;Kim, Yong-Woo;Kim, Young-Ku;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.39-51
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    • 2011
  • The aims of this study were to investigate whether the facial skeletal patterns previously reported to be related to temporomandibular disorder (TMD) in other studies could be consistently observed in the TMD patients diagnosed according to Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD) Axis I and evaluate its usability in the orthodontic clinics to examine the patients with TMD related symptoms. The clinical records and radiographs of female patients who visited the TMD and Orofacial Pain Clinic of Seoul National University Dental Hospital and were diagnosed as TMD were consecutively filed for this study. Patients were clinically examined and diagnosed according to the revised diagnostic algorithms of RDC/TMD Axis I and the lateral cephalogram, panoramic orthopantomogram, temporomandibular joint (TMJ) orthopantomogram, and transcranial radiograph of each patient were taken and digitalized. The data of patients who were under 18 years of age or had any systemic disease, trauma history involving the TMJ, or skeletal deformity at the time of the first examination were excluded. The remaining data of 96 female patients were finally analyzed. The obtained results were as follows: 1. There are no significant differences of cephalometric measurements between RDC I (muscle disorders) diagnostic groups. 2. Only the articular angle of the RDC group IIc (disk displacement without reduction without limited opening) patients was larger than patients of the no diagnosis of RDC II group (disk displacement). 3. Larger articular angle and smaller facial height ratio were observed in RDC IIIc group (osteoarthrosis) compared to IIIa group (arthralgia). Larger articular angle, larger Bjork sum, smaller posterior facial height, and smaller facial height ratio were observed in RDC group IIIc compared to no diagnosis of RDC III group (arthralgia, arthritis, and arthrosis). 4. According to the results of cephalometric analysis in simplified RDC groups, smaller overjet was observed in muscle disorders (MD) group. Facial height ratio and IMPA were smaller and articular angle was larger in disk displacements (DD) group than in no diagnosis of DD group. In arthrosis (AR) group, posterior facial height, and facial height ratio were smaller, and articular angle, gonial angle, facial convexity, FMA, Bjork sum, and ANB were larger than in no diagnosis of AR group. In joint pain (JP) group, only posterior facial height was smaller than no diagnosis of JP group. In conclusion, Facial morphologic patterns showing posterior-rotated mandible and lower posterior facial height is related to RDC group II and III diagnosis of the TMJ in female TMD patients. RDC/TMD Axis I diagnosis can provide a good clinical diagnostic tool for the standardized examination of the TMJ in orthodontic clinics.

The Effects of Music Therapy on recovery of consciousness and vital signs in post operative patient in the recovery room (음악요법이 수술직후 환자의 의식회복과 활력징후에 미치는 영향)

  • Kim Sook-Jung;Jun Eun-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.222-238
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    • 2000
  • The purpose of this study was to demonstrate the effect of music therapy as a nursing intervention on changes in recovery of consciousness and vital signs for postoperative patients in the recovery room. The subject for this study were fifty three of postoperative patients who were transferred from the OR to the RR at Kwangju Christian Hospital in Kwangju City. Thirty of them were assigned to the experimental group, and twenty three, to the control group. The age of the subject was between twenty and sixty years of age. The subject had a general anesthesia without any special complications, and they were not completely awake. The data were collected for six months from July 1999 to February 2000. The method used was to compare the condition of the subjects in each group at the beginning and at certain times repeatedly. The features observed were the level of consciousness, the frequency of complaints of pain, and vital signs of the subject before and 15 minutes, 30 minutes, and 60 minutes after hearing their favorite music for 30 minutes. The results are as follows 1. The recovery of consciousness was revealed through significant changes in facial expression, facial color, and grip strength in the experimental group more strongly than in the control group. No significant changes were shown in verbal order. The differences in recovery of consciousness in the pre-post music therapy between the two groups was not significant in verbal order, facial expression, or grip strength. However, significant changes were seen in facial color. 2. There were no significant differences between the two groups in changes in the frequency of pain complaints after music therapy. However, a significant difference was shown in the pre-post music therapy scres. 3. Vital signs did not show a significant difference between the two groups. However, the $SPO_2$ of the experimental group was significantly elevated after 60 minutes. The difference pre-post to the music therapy in the vital signs between two groups was significant only in body temperature. This study showed that the effect of music therapy given to postoperative patients is that it promotes changes in facial expression, facial color, and grip strength helping recovery of consciousness, stabilizing vital signs, elevating levels of $SPO_2$. and reducing complaints of pain. It is recommended that if the patient wants it music therapy be given right after surgery in the recovery room as a nursing intervention.

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A Clinical Review of Parotid Tumor (이하선 종양의 임상적 고찰)

  • Kang Gyeong-Beom;Oh Sung-Soo;Park Sung-Gil;Seel David J.;Park Yoon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.221-227
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    • 1997
  • The authors reviewed 106 cases of parotid gland tumor at Presbyterian Medical Center seen during the past 10 years between January, 1986 and December, 1995. The results were obtained as follows; 1) 86 cases(81.1%) were benign tumors and 20 cases(18.9%) were malignant tumors. 2) Overall male and female sex ratio was 1 : 1.4. 3) For benign tumors, the mean age was 47.9 and for malignant tumors, the mean age was 43.4. 4) Clinical manifestations in benign tumors were palpable mass in 86 cases(100%), pain in 6 cases(6.9%), facial nerve palsy in 2 cases(2.3%), lymphadenopathy in 1 case(1.2%); and in malignant tumors, palpable mass in 20 cases(100%), pain in 7 cases(35%), facial nerve palsy in 2 cases(10%) and lymphadenopathy in 3 cases(15%). Thus, the presence of pain, facial nerve palsy and lymphadenopathy suggest malignant tumors. 5) Operative procedures in benign tumors included superficial parotidectomy in 53 cases(61.6%), total parotidectomy in 10 cases(11.6%), local excision in 23 cases(26.7%); and in malignant tumors, superficial parotidectomy in 3 cases, total parotidectomy in 1 case, local excision in 1 case, superficial parotidectomy with supraomohyoid neck dissection in 6 cases, total parotidectomy with supraomohyoid neck dissection in 8 cases, total parotidectomy with radical neck dissection in 1 case. 6) Postoperative complications in benign tumors were transient facial nerve palsy in 14 cases, Frey's syndrome in 2 cases. In malignant tumors complications included transient facial nerve palsy in 3 cases and permanent facial nerve palsy in 1 case. 7) Pleomorphic adenoma was the most common benign parotid tumor and mucoepidermoid carcinoma was the most common malignant tumor. 8) In our review of 20 patients with malignant parotid tumors, all patients who received supraomohyoid neck dissection and postoperative radiation therapy remain alive from 1986 to 1995 years. Two deaths in this series were adenoid cystic carcinoma patients who failed to receive postoperative radiation therapy. These series of cases have been studied in order to determine whether supraomohyoid neck dissection and postoperative radiation therapy may have further therapeutic effect.

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Alcohol Neurolysis for the Treatment of Trigeminal Neuralgia (Alcohol Neurolysis를 이용한 삼차 신경통 치험예)

  • Choe, Huhn
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.45-48
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    • 1989
  • Trigeminal neuralgia is one of the diseases which cause most chronic and intractable pain on the facial area. Several drugs includding analgegics, anticonvulsants, tranquilizers, vitamins or hormonal preparations have been expected to be effective but no drug could effectively relieve the patients from the pain. The pain could be relieved by surgical neurectomy or neurolysis of the Gasserian ganglion or the involved branches with absolute alcohol alternatively. Surgical microvascular decompression may be performed if the pain resulted from compression of the nerve by adjucent arterial loops. 4 cases of trigeminal neuralgia are presented. They were treated with alcohol neurolysis of the involved peripheral nerves combined with or without carbamazepine and/or amitriptyline with favorable result of pain relief.

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Assessing the Public's Interest in Orofacial Pain Specialists: A Google Trends Analysis

  • Jack Botros;Mariela Padilla
    • Journal of Oral Medicine and Pain
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    • v.48 no.4
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    • pp.137-143
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    • 2023
  • Purpose: To assess Google Trends (GT) search behavior regarding orofacial pain (OFP) and headaches. Methods: GT scores for OFP and headache specialists between February 2013 and December 2022 were analyzed. Statistical tests such as Poisson regression analyses, mean differences, and Cohen's D were used to assess the score change over time. Results: The top three search words for OFP specialists were "temporomandibular joint (TMJ) specialist," "TMJ doctor," and "TMJ dentist," whereas the top three search words for headache specialists were "Headache specialist," "Headache doctor," and "Migraine specialist." Here, TMJ is temporomandibular joint. The GT scores for OFP specialists increased significantly (p<0.05) for all years except 2017, with the highest mean difference in 2020. The scores for headache specialists showed similar trends but gradually. Conclusions: The interest in OFP and headache specialists expressed by Google searches has increased over the years. More awareness is needed regarding the OFP scope of practice, and the use of GT may serve as an indicator.

A Case of Urticaria and Angioedema Caused from Serum Sickness Reaction by Bee Venom (벌독으로 인한 혈청병 양상의 두드러기 및 맥관부종 치험 1례)

  • Kim, Jung-Hyun;Kang, Da-Hae;Kim, Jee-Young;Lim, Hae-Won;Kim, Ja-Heon;Kwon, Kang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.24 no.3
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    • pp.138-146
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    • 2011
  • Objective : This study was performed to prove the effect of the oriental medical treatments on urticaria and angioedema caused from serum sickness reaction by bee venom. Method : We treated one case of urticaria and angioedema with oriental medical treatments such as 8 constitution acupuncture, herbal medicine, venesection therapy and facial pack therapy. We took pictures through the treatment to evaluate the improvement. Six items, itching, burning sensation, pain, wheal, redness, edema were used to diagnose urticaria and angioedema. Result & Conclusion : After treatments the urticaria and angioedema were improved. The symptom of itching, heating, pain, wheal, redness of whole body and facial edema disappeared.

Unintentional temporomandibular joint disc reduction after orthognathic surgery: A case report with long-term imaging follow-up

  • Hak-Sun, Kim;Sang-Sun, Han;Chena, Lee
    • Imaging Science in Dentistry
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    • v.52 no.4
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    • pp.409-413
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    • 2022
  • This report presents a rare case where a displaced temporomandibular joint (TMJ) disc was reduced to its normal position after orthognathic surgery, and long-term magnetic resonance imaging (MRI) follow-up visualized these postoperative changes. A 22-year-old male patient presented for facial asymmetry. He also complained of pain in the right TMJ area, and MRI showed disc displacements in both TMJs. After orthognathic surgery for facial asymmetry correction, the TMJ was re-evaluated. The symptom had resolved and the disc was positioned within the normal range during mouth opening. However, 6 and a half years after surgery, he complained of recurrent pain in the right joint, and MRI revealed medial disc displacement in the right TMJ. In conclusion, the influence of orthognathic surgery on the disc position might continue for a long time until the TMJ adapts to the new position. Careful and long-term follow-up is suggested to assess the TMJ complex.